Cochrane · systematic review · CD001537
Interventions for minimal change disease in adults with nephrotic syndrome
Azukaitis, K, Palmer, SC, Strippoli, GFM, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Kidney and TransplantAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
25
No studies
1
Included studies
NR
No studies 1 · 3.8%Ungraded 0 · 0%Very low 10 · 38.5%Low 9 · 34.6%Moderate 6 · 23.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Steroids versus no specific treatment for minimal change disease in adults with nephrotic syndrome
Population: minimal change disease in adults with nephrotic syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete remission Time frame: to 77 months Steroids vs no specific treatment | RR 1.44 [0.95, 2.19] | 1 study · 28 participants | Very low Downgraded: risk of bias |
Complete or partial remission Time frame: to 77 months Steroids vs no specific treatment | RR 1.38 [0.98, 1.95] | 1 study · 28 participants | Very low Downgraded: risk of bias |
Relapse during Steroids vs no specific treatment | RR 0.75 [0.48, 1.17] | 1 study · 28 participants | Very low Downgraded: risk of bias |
Adverse events: avascular necrosis Steroids vs no specific treatment | RR 3 [0.13, 67.91] | 1 study · 28 participants | Very low Downgraded: risk of bias |
Adverse events: doubling serum creatinine Steroids vs no specific treatment | RR 0.11 [0.01, 1.89] | 1 study · 28 participants | Very low Downgraded: risk of bias |
Adverse events: kidney failure Steroids vs no specific treatment | RR 0.33 [0.01, 7.55] | 1 study · 28 participants | Very low Downgraded: risk of bias |
Intravenous ± oral steroids versus oral steroids alone for minimal change disease in adults with nephrotic syndrome
Population: minimal change disease in adults with nephrotic syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete remission Time frame: 2 to 28 months Intravenous ± oral steroids vs oral steroids alone | RR 1.76 [0.17, 18.32] | 2 studies · 35 participants | Very low Downgraded: risk of bias |
Complete or partial remission Intravenous ± oral steroids vs oral steroids alone | no estimate extracted | NR | No studies |
Relapse during Intravenous ± oral steroids vs oral steroids alone | RR 1.18 [0.65, 2.15] | 1 study · 19 participants | Very low Downgraded: risk of bias |
Adverse events: thromboses Intravenous ± oral steroids vs oral steroids alone | RR 0.5 [0.05, 4.75] | 1 study · 22 participants | Very low Downgraded: risk of bias |
Adverse events: gastrointestinal bleeding Intravenous ± oral steroids vs oral steroids alone | RR 0.13 [0.15, 0.4] | 1 study · 18 participants | Very low Downgraded: risk of bias |
Calcineurin inhibitors ± oral steroids versus oral steroids alone for minimal change disease in adults with nephrotic syndrome
Population: minimal change disease in adults with nephrotic syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete remission Time frame: 2 to 6 months Calcineurin inhibitors ± oral steroids vs oral steroids alone | RR 0.99 [0.93, 1.05] | 8 studies · 492 participants | Moderate Downgraded: risk of bias |
Complete or partial remission time frame: 3 to 6 months Calcineurin inhibitors ± oral steroids vs oral steroids alone | RR 1.01 [0.96, 1.05] | 4 studies · 269 participants | Moderate Downgraded: risk of bias |
Relapse Time frame: 6 to 12 months Calcineurin inhibitors ± oral steroids vs oral steroids alone | RR 0.73 [0.51, 1.03] | 7 studies · 422 participants | Moderate Downgraded: risk of bias |
Adverse effects: diabetes or hyperglycaemia Calcineurin inhibitors ± oral steroids vs oral steroids alone | RR 0.48 [0.19, 1.25] | 7 studies · 450 participants | Low Downgraded: risk of bias |
Adverse effects: obesity or Cushing's Syndrome Calcineurin inhibitors ± oral steroids vs oral steroids alone | RR 0.11 [0.02, 0.59] | 5 studies · 388 participants | Low Downgraded: risk of bias |
Adverse effects: hypertension Calcineurin inhibitors ± oral steroids vs oral steroids alone | RR 0.86 [0.23, 3.2] | 3 studies · 219 participants | Low Downgraded: risk of bias |
Adverse events: acute kidney injury Calcineurin inhibitors ± oral steroids vs oral steroids alone | RR 1.78 [0.35, 8.99] | 4 studies · 270 participants | Low Downgraded: risk of bias |
Adverse effects: acne Calcineurin inhibitors ± oral steroids vs oral steroids alone | RR 0.15 [0.03, 0.67] | 4 studies · 270 participants | Low Downgraded: risk of bias |
Mycophenolate sodium + oral steroids versus oral steroids alone for minimal change disease in adults with nephrotic syndrome
Population: minimal change disease in adults with nephrotic syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete remission Time frame: 4 weeks Mycophenolate sodium + oral steroids vs oral steroids alone | RR 1.12 [0.84, 1.5] | 1 study · 114 participants | Moderate Downgraded: imprecision |
Complete remission Time frame: 24 weeks to end of treatment Mycophenolate sodium + oral steroids vs oral steroids alone | RR 1.08 [0.84, 1.38] | 2 studies · 134 participants | Moderate Downgraded: imprecision, inconsistency |
Complete or partial remission Time frame: 24 weeks to end of treatment Mycophenolate sodium + oral steroids vs oral steroids alone | RR 0.92 [0.75, 1.12] | 2 studies · 134 participants | Moderate Downgraded: imprecision, inconsistency |
Relapse Time frame: 24 weeks Mycophenolate sodium + oral steroids vs oral steroids alone | RR 0.43 [0.08, 2.25] | 2 studies · 80 participants | Low Downgraded: imprecision, inconsistency |
Adverse events: death Mycophenolate sodium + oral steroids vs oral steroids alone | RR 0.67 [0.12, 3.84] | 1 study · 116 participants | Low Downgraded: imprecision, inconsistency |
Adverse events: acute kidney injury Mycophenolate sodium + oral steroids vs oral steroids alone | RR 0.5 [0.05, 5.36] | 1 study · 116 participants | Low Downgraded: imprecision, inconsistency |
Adverse events: new‐onset glucose intolerance Mycophenolate sodium + oral steroids vs oral steroids alone | RR 0.2 [0.01, 4.08] | 2 studies · 136 participants | Low Downgraded: imprecision, inconsistency |